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Knöchel C, Voss M, Grüter F, Alves GS, Matura S, Sepanski B, Stäblein M, Wenzler S, Prvulovic D, Carvalho AF, Oertel-Knöchel V. Omega 3 Fatty Acids: Novel Neurotherapeutic Targets for Cognitive Dysfunction in Mood Disorders and Schizophrenia? Curr Neuropharmacol 2016; 13:663-80. [PMID: 26467414 PMCID: PMC4761636 DOI: 10.2174/1570159x13666150630173047] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 02/25/2015] [Accepted: 02/27/2015] [Indexed: 01/23/2023] Open
Abstract
An increasing body of evidences from preclinical as well as epidemiological and clinical
studies suggest a potential beneficial role of dietary intake of omega-3 fatty acids for cognitive functioning.
In this narrative review, we will summarize and discuss recent findings from epidemiological, interventional
and experimental studies linking dietary consumption of omega-3 fatty acids to cognitive
function in healthy adults. Furthermore, affective disorders and schizophrenia (SZ) are characterized
by cognitive dysfunction encompassing several domains. Cognitive dysfunction is closely related to impaired functioning
and quality of life across these conditions. Therefore, the current review focues on the potential influence of omega-3 fatty
acids on cognition in SZ and affective disorders. In sum, current data predominantly from mechanistic models and animal
studies suggest that adjunctive omega-3 fatty acid supplementation could lead to improved cognitive functioning in SZ
and affective disorders. However, besides its translational promise, evidence for clinical benefits in humans has been
mixed. Notwithstanding evidences indicate that adjunctive omega-3 fatty acids may have benefit for affective symptoms
in both unipolar and bipolar depression, to date no randomized controlled trial had evaluated omega-3 as cognitive
enhancer for mood disorders, while a single published controlled trial suggested no therapeutic benefit for cognitive
improvement in SZ. Considering the pleiotropic mechanisms of action of omega-3 fatty acids, the design of well-designed
controlled trials of omega-3 supplementation as a novel, domain-specific, target for cognitive impairment in SZ and
affective disorders is warranted.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Viola Oertel-Knöchel
- Laboratory for Neuroimaging, Dept. of Psychiatry, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy; Heinrich-Hoffmann-Str. 10, Goethe-University, 60528 Frankfurt
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van der Stouwe ECD, de Vries B, Aleman A, Arends J, Waarheid C, Meerdink A, van der Helm E, van Busschbach JT, Pijnenborg GHM. BEATVIC, a body-oriented resilience training with elements of kickboxing for individuals with a psychotic disorder: study protocol of a multi-center RCT. BMC Psychiatry 2016; 16:227. [PMID: 27393604 PMCID: PMC4938955 DOI: 10.1186/s12888-016-0918-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/08/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Individuals with a psychotic disorder are at an increased risk of becoming victim of a crime or other forms of aggression. Research has revealed several possible risk factors (e.g. impaired social cognition, aggression regulation problems, assertiveness, self-stigma, self-esteem) for victimization in patients with a psychotic disorder. To address these risk factors and prevent victimization, we developed a body-oriented resilience training with elements of kickboxing: BEATVIC. The present study aims to evaluate the effectiveness of the intervention. METHODS/DESIGN Seven mental health institutions in the Netherlands will participate in this study. Participants will be randomly assigned to either the BEATVIC training or the control condition: social activation. Follow-ups are at 6, 18 and 30 months. Short term effects on risk factors for victimization will be examined, since these are direct targets of the intervention and are thought to be mediators of victimization, the primary outcome of the intervention. The effect on victimization will be investigated at follow-up. In a subgroup of patients, fMRI scans will be made before and after the intervention period in order to assess potential neural changes associated with the effects of the training. DISCUSSION This study is the first to examine the effectiveness of an intervention targeted at victimization in psychosis. Methodological issues of the study are addressed in the discussion of this paper. TRIAL REGISTRATION Current Controlled Trials: ISRCTN21423535 . Retrospectively registered 30-03-2016.
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Affiliation(s)
- Elisabeth C. D. van der Stouwe
- Department of Neuroscience, BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands ,University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Bertine de Vries
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - André Aleman
- Department of Neuroscience, BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands ,Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Johan Arends
- Department of Psychotic Disorders, GGZ-Drenthe, Dennenweg 9, 9404 LA Assen, The Netherlands
| | - Clement Waarheid
- Department of Psychotic Disorders, GGZ-Drenthe, Dennenweg 9, 9404 LA Assen, The Netherlands
| | - Aniek Meerdink
- Department of Psychotic Disorders, GGZ-Drenthe, Dennenweg 9, 9404 LA Assen, The Netherlands
| | | | - Jooske T. van Busschbach
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ Groningen, The Netherlands ,Department of Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
| | - Gerdina H. M. Pijnenborg
- Department of Neuroscience, BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands ,University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ Groningen, The Netherlands ,Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands ,Department of Psychotic Disorders, GGZ-Drenthe, Dennenweg 9, 9404 LA Assen, The Netherlands
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Chen MD, Kuo YH, Chang YC, Hsu ST, Kuo CC, Chang JJ. Influences of Aerobic Dance on Cognitive Performance in Adults with Schizophrenia. Occup Ther Int 2016; 23:346-356. [DOI: 10.1002/oti.1436] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 04/21/2016] [Accepted: 05/31/2016] [Indexed: 12/25/2022] Open
Affiliation(s)
- Ming-De Chen
- Department of Occupational Therapy; Kaohsiung Medical University; Kaohsiung City Taiwan
| | - Yu-Hsin Kuo
- Department of Psychiatry; Kaohsiung Chang Gung Memorial Hospital; Kaohsiung City Taiwan
| | - Yen-Ching Chang
- Department of Occupational Therapy; National Cheng Kung University; Tainan City Taiwan
| | - Su-Ting Hsu
- Department of Community Psychiatry; Kaohsiung Kai-Syuan Psychiatric Hospital; Kaohsiung City Taiwan
| | - Chang-Chih Kuo
- Department of Occupational Therapy; Kaohsiung Medical University; Kaohsiung City Taiwan
| | - Jyh-Jong Chang
- Department of Occupational Therapy; Kaohsiung Medical University; Kaohsiung City Taiwan
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Malchow B, Keeser D, Keller K, Hasan A, Rauchmann BS, Kimura H, Schneider-Axmann T, Dechent P, Gruber O, Ertl-Wagner B, Honer WG, Hillmer-Vogel U, Schmitt A, Wobrock T, Niklas A, Falkai P. Effects of endurance training on brain structures in chronic schizophrenia patients and healthy controls. Schizophr Res 2016; 173:182-191. [PMID: 25623601 DOI: 10.1016/j.schres.2015.01.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 12/19/2014] [Accepted: 01/02/2015] [Indexed: 11/19/2022]
Abstract
The objective of this longitudinal magnetic resonance (MR) imaging study was to examine the effects of endurance training on hippocampal and grey matter volumes in schizophrenia patients and healthy controls. 20 chronic schizophrenia patients and 21 age- and gender-matched healthy controls underwent 3months of endurance training (30min, 3 times per week). 19 additionally recruited schizophrenia patients played table soccer ("foosball" in the USA) over the same period. MR imaging with 3D-volumetric T1-weighted sequences was performed on a 3T MR scanner at baseline, after 6weeks and after the 3-month intervention and 3 additional training-free months. In addition to voxel-based morphometry (VBM), we performed manual and automatic delineation of the hippocampus and its substructures. Endurance capacity and psychopathological symptoms were measured as secondary endpoints. No significant increases in the volumes of the hippocampus or hippocampal substructures were observed in schizophrenia patients or healthy controls. However, VBM analyses displayed an increased volume of the left superior, middle and inferior anterior temporal gyri compared to baseline in schizophrenia patients after the endurance training, whereas patients playing table soccer showed increased volumes in the motor and anterior cingulate cortices. After the additional training-free period, the differences were no longer present. While endurance capacity improved in exercising patients and healthy controls, psychopathological symptoms did not significantly change. The subtle changes in the left temporal cortex indicate an impact of exercise on brain volumes in schizophrenia. Subsequent studies in larger cohorts are warranted to address the question of response variability of endurance training.
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Affiliation(s)
- Berend Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Institute of Clinical Radiology, Ludwig-Maximilian-University, Munich, Germany
| | - Katriona Keller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Department of Sports Medicine, University Medical Center Goettingen, Goettingen, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | | | - Hiroshi Kimura
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Peter Dechent
- MR Research in Neurology and Psychiatry, Department of Cognitive Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Oliver Gruber
- Centre for Translational Research in Systems Neuroscience and Clinical Psychiatry, Georg August University, Goettingen, Germany
| | - Birgit Ertl-Wagner
- Institute of Clinical Radiology, Ludwig-Maximilian-University, Munich, Germany
| | - William G Honer
- Institute of Mental Health, The University of British Columbia, Vancouver, Canada
| | - Ursula Hillmer-Vogel
- Department of Sports Medicine, University Medical Center Goettingen, Goettingen, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Thomas Wobrock
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany; Centre of Mental Health, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
| | - Andree Niklas
- Department of Sports Medicine, University Medical Center Goettingen, Goettingen, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
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Depp CA, Dev S, Eyler LT. Bipolar Depression and Cognitive Impairment: Shared Mechanisms and New Treatment Avenues. Psychiatr Clin North Am 2016; 39:95-109. [PMID: 26876321 PMCID: PMC4758200 DOI: 10.1016/j.psc.2015.09.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Depression and cognitive impairment are pervasive and highly disabling aspects of bipolar disorder. Although cognitive impairment is partially independent from mood episodes, depressive symptoms may increase the risk of cognitive impairment in bipolar disorder through inflammatory processes as well as health risks such as obesity and sedentary behavior. Novel treatment avenues at the intersection of bipolar depression and cognitive impairment target inflammation directly or indirectly health behaviors such as diet, physical activity, and sleep hygiene.
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Affiliation(s)
- Colin A Depp
- Department of Psychiatry, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Desert-Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
| | - Sheena Dev
- Department of Psychiatry, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; SDSU-UCSD Joint Doctoral Program, Clinical Psychology, San Diego, CA, USA
| | - Lisa T Eyler
- Department of Psychiatry, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Desert-Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA
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Prefrontal and Hippocampal Brain Volume Deficits: Role of Low Physical Activity on Brain Plasticity in First-Episode Schizophrenia Patients. J Int Neuropsychol Soc 2015; 21:868-79. [PMID: 26581798 PMCID: PMC4654705 DOI: 10.1017/s1355617715000983] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
UNLABELLED Our objective in the present study was to conduct the first empirical study of the effects of regular physical activity habits and their relationship with brain volume and cortical thickness in patients in the early phase of schizophrenia. Relationships between larger brain volumes and higher physical activity levels have been reported in samples of healthy and aging populations, but have never been explored in first-episode schizophrenia patients. METHOD We collected MRI structural scans in 14 first-episode schizophrenia patients with either self-reported low or high physical activity levels. We found a reduction in total gray matter volume, prefrontal cortex (PFC), and hippocampal gray matter volumes in the low physical activity group compared to the high activity group. Cortical thickness in the dorsolateral and orbitofrontal PFC were also significantly reduced in the low physical activity group compared to the high activity group. In the combined sample, greater overall physical activity levels showed a non-significant tendency with better performance on tests of verbal memory and social cognition. Together these pilot study findings suggest that greater amounts of physical activity may have a positive influence on brain health and cognition in first-episode schizophrenia patients and support the implementation of physical exercise interventions in this patient population to improve brain plasticity and cognitive functioning.
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Jiang P, Zhu T, Xia Z, Gao F, Gu W, Chen X, Yuan T, Yu H. Inhibition of MAPK/ERK signaling blocks hippocampal neurogenesis and impairs cognitive performance in prenatally infected neonatal rats. Eur Arch Psychiatry Clin Neurosci 2015; 265:497-509. [PMID: 25721317 DOI: 10.1007/s00406-015-0588-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 02/19/2015] [Indexed: 12/20/2022]
Abstract
Hippocampus endogenous neurogenesis has been postulated to play a favorable role in brain restoration after injury. However, the underlying molecular mechanisms have been insufficiently deciphered. Here we investigated the potential regulatory capacity of MAPK/ERK signaling on neurogenesis and the associated cognitive performance in prenatally infected neonatal rats. From our data, intrauterine infection could induce hippocampal neuronal apoptosis and promote endogenous repair by evoking neural stem cell proliferation and survival. We also found intrauterine infection could induce increased levels of p-ERK, p-CREB and BDNF, which might be responsible for the potential endogenous rescue system. Furthermore, inhibition of MAPK/ERK signaling could aggravate hippocampal neuronal apoptosis, decrease neurogenesis, and impair the offspring's cognitive performances and could also down-regulate the levels of p-ERK, p-CREB and BDNF. Our data strongly suggest that the activation of MAPK/ERK signaling may play a significant role in promoting survival of newly generated neural stem cells via an anti-apoptotic mechanism, which may be particularly important in endogenous neuroprotection associated with cognitive performance development in prenatally infected rats.
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Affiliation(s)
- Peifang Jiang
- Department of Neurology, Children's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Archer T, Kostrzewa RM. Physical Exercise Alleviates Health Defects, Symptoms, and Biomarkers in Schizophrenia Spectrum Disorder. Neurotox Res 2015; 28:268-80. [PMID: 26174041 DOI: 10.1007/s12640-015-9543-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/08/2015] [Accepted: 07/06/2015] [Indexed: 02/07/2023]
Abstract
Schizophrenia spectrum disorders are characterized by symptom profiles consisting of positive and negative symptoms, cognitive impairment, and a plethora of genetic, epigenetic, and phenotypic biomarkers. Assorted animal models of these disorders and clinical neurodevelopmental indicators have implicated neurodegeneration as an element in the underlying pathophysiology. Physical exercise or activity regimes--whether aerobic, resistance, or endurance--ameliorate regional brain and functional deficits not only in affected individuals but also in animal models of the disorder. Cognitive deficits, often linked to regional deficits, were alleviated by exercise, as were quality-of-life, independent of disorder staging and risk level. Apoptotic processes intricate to the etiopathogenesis of schizophrenia were likewise attenuated by physical exercise. There is also evidence of manifest benefits endowed by physical exercise in preserving telomere length and integrity. Not least, exercise improves overall health and quality-of-life. The notion of scaffolding as the outcome of physical exercise implies the "buttressing" of regional network circuits, neurocognitive domains, anti-inflammatory defenses, maintenance of telomeric integrity, and neuro-reparative and regenerative processes.
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Affiliation(s)
- Trevor Archer
- Department of Psychology, University of Gothenburg, 405 30, Gothenburg, Sweden,
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Malchow B, Keller K, Hasan A, Dörfler S, Schneider-Axmann T, Hillmer-Vogel U, Honer WG, Schulze TG, Niklas A, Wobrock T, Schmitt A, Falkai P. Effects of Endurance Training Combined With Cognitive Remediation on Everyday Functioning, Symptoms, and Cognition in Multiepisode Schizophrenia Patients. Schizophr Bull 2015; 41:847-58. [PMID: 25782770 PMCID: PMC4466186 DOI: 10.1093/schbul/sbv020] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aerobic exercise has been shown to improve symptoms in multiepisode schizophrenia, including cognitive impairments, but results are inconsistent. Therefore, we evaluated the effects of an enriched environment paradigm consisting of bicycle ergometer training and add-on computer-assisted cognitive remediation (CACR) training. To our knowledge, this is the first study to evaluate such an enriched environment paradigm in multiepisode schizophrenia. Twenty-two multiepisode schizophrenia patients and 22 age- and gender-matched healthy controls underwent 3 months of endurance training (30min, 3 times/wk); CACR training (30min, 2 times/wk) was added from week 6. Twenty-one additionally recruited schizophrenia patients played table soccer (known as "foosball" in the United States) over the same period and also received the same CACR training. At baseline and after 6 weeks and 3 months, we measured the Global Assessment of Functioning (GAF), Social Adjustment Scale-II (SAS-II), schizophrenia symptoms (Positive and Negative Syndrome Scale), and cognitive domains (Verbal Learning Memory Test [VLMT], Wisconsin Card Sorting Test [WCST], and Trail Making Test). After 3 months, we observed a significant improvement in GAF and in SAS-II social/leisure activities and household functioning adaptation in the endurance training augmented with cognitive remediation, but not in the table soccer augmented with cognitive remediation group. The severity of negative symptoms and performance in the VLMT and WCST improved significantly in the schizophrenia endurance training augmented with cognitive remediation group from week 6 to the end of the 3-month training period. Future studies should investigate longer intervention periods to show whether endurance training induces stable improvements in everyday functioning.
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Affiliation(s)
- Berend Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany;
| | - Katriona Keller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany;,Department of Sports Medicine, University Medical Center Goettingen, Goettingen, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Sebastian Dörfler
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany
| | | | - Ursula Hillmer-Vogel
- Department of Sports Medicine, University Medical Center Goettingen, Goettingen, Germany
| | - William G. Honer
- Institute of Mental Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics, Ludwig Maximilian University, Munich, Germany
| | - Andree Niklas
- Department of Sports Medicine, University Medical Center Goettingen, Goettingen, Germany
| | - Thomas Wobrock
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany;,Center of Mental Health, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany;,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
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Exercise prevents downregulation of hippocampal presynaptic proteins following olanzapine-elicited metabolic dysregulation in rats: Distinct roles of inhibitory and excitatory terminals. Neuroscience 2015; 301:298-311. [PMID: 26086543 DOI: 10.1016/j.neuroscience.2015.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/09/2015] [Accepted: 06/11/2015] [Indexed: 12/22/2022]
Abstract
Schizophrenia patients treated with olanzapine, or other second-generation antipsychotics, frequently develop metabolic side-effects, such as glucose intolerance and increased adiposity. We previously observed that modeling these adverse effects in rodents also resulted in hippocampal shrinkage. Here, we investigated the impact of olanzapine treatment, and the beneficial influence of routine exercise, on the neurosecretion machinery of the hippocampus. Immunodensities and interactions of three soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) proteins (syntaxin-1, synaptosome-associated protein of 25kDa (SNAP-25) and vesicle-associated membrane protein (VAMP)), synaptotagmin and complexins-1/2 were quantified in the hippocampus of sedentary and exercising rats exposed over 9weeks to vehicle (n=28) or olanzapine (10mg/kg/day, n=28). In addition, brain sections from subgroups of sedentary animals (n=8) were co-immunolabeled with antibodies against vesicular GABA (VGAT) and glutamate (VGLUT1) transporters, along with syntaxin-1, and examined by confocal microscopy to detect selective olanzapine effects within inhibitory or excitatory terminals. Following olanzapine treatment, sedentary, but not exercising rats showed downregulated (33-50%) hippocampal densities of SNARE proteins and synaptotagmin, without altering complexin levels. Strikingly, these effects had no consequences on the amount of SNARE protein-protein interactions. Lower immunodensity of presynaptic proteins was associated with reduced CA1 volume and glucose intolerance. Syntaxin-1 depletion appeared more prominent in VGAT-positive terminals within the dentate gyrus, and in non-VGAT/VGLUT1-overlapping areas of CA3. The present findings suggest that chronic exposure to olanzapine may alter hippocampal connectivity, especially in inhibitory terminals within the dentate gyrus, and along the mossy fibers of CA3. Together with previous studies, we propose that exercise-based therapies might be beneficial for patients being treated with olanzapine.
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Stanton R, Rosenbaum S, Kalucy M, Reaburn P, Happell B. A call to action: exercise as treatment for patients with mental illness. Aust J Prim Health 2015; 21:120-5. [DOI: 10.1071/py14054] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 07/01/2014] [Indexed: 12/17/2022]
Abstract
Mental illness affects the lives of a significant number of Australians. In addition to pharmacological and psychological interventions, exercise has demonstrated benefits for people with mental illness including symptom reduction, improved cardiovascular risk profile and improved physical capacity. Unfortunately, evidence shows that clinician-delivered exercise advice is not routinely offered. This is despite patient acceptability for exercise. This article summarises the recent evidence supporting the prescription of exercise for people with mental illness and offers a model incorporating basic exercise prescription, and referral pathways for specialised advice. Current exercise prescription patterns for people with mental illness may not meet patient expectations; therefore, clinicians should consider exercise referral schemes to increase the accessibility of interventions for people with a mental illness.
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Unraveling exercise addiction: the role of narcissism and self-esteem. JOURNAL OF ADDICTION 2014; 2014:987841. [PMID: 25405056 PMCID: PMC4227365 DOI: 10.1155/2014/987841] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 10/10/2014] [Accepted: 10/10/2014] [Indexed: 12/17/2022]
Abstract
The aim of this study was to assess the risk of exercise addiction (EA) in fitness clubs and to identify possible factors in the development of the disorder. The Exercise Addiction Inventory (EAI), the Narcissistic Personality Inventory (NPI), and the Coopersmith Self-Esteem Inventory (SEI) were administered to a sample of 150 consecutive gym attenders recruited in fitness centers. Based on EAI total score, high EA risk group (HEA n = 51) and a low EA risk group (LEA n = 69) were identified. HEA reported significantly higher total score (mean = 20.2 versus 14.6) on the NPI scale and lower total score (mean = 32.2 versus 36.4) on the SEI scale than LEA. A stepwise regression analysis indicated that only narcissism and self-esteem total scores (F = 5.66; df = 2; P = 0.006) were good predictors of days per week exercise. The present study confirms the direct and combined role of both labile self-esteem and high narcissism in the development of exercise addiction as predictive factors towards the risk of addiction. Multidisciplinary trained health care providers (physiatrists, psychologists, and psychiatrists) should carefully identify potential overexercise conditions in order to prevent the potential risk of exercise addiction.
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Effects of aerobic exercise on cognitive performance and individual psychopathology in depressive and schizophrenia patients. Eur Arch Psychiatry Clin Neurosci 2014; 264:589-604. [PMID: 24487666 DOI: 10.1007/s00406-014-0485-9] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 01/13/2014] [Indexed: 12/24/2022]
Abstract
Cognitive deficits are core symptoms in patients with schizophrenia (SZ) and major depressive disorder (MDD), but specific and approved treatments for cognitive deterioration are scarce. Experimental and clinical evidence suggests that aerobic exercise may help to reduce psychopathological symptoms and support cognitive performance, but this has not yet been systematically investigated. In the current study, we examined the effects of aerobic training on cognitive performance and symptom severity in psychiatric inpatients. To our knowledge, to date, no studies have been published that directly compare the effects of exercise across disease groups in order to acquire a better understanding of disease-specific versus general or overlapping effects of physical training intervention. Two disease groups (n=22 MDD patients, n=29 SZ patients) that were matched for age, gender, duration of disease and years of education received cognitive training combined either with aerobic physical exercise or with mental relaxation training. The interventions included 12 sessions (3 times a week) over a time period of 4 weeks, lasting each for 75 min (30 min of cognitive training+45 min of cardio training/mental relaxation training). Cognitive parameters and psychopathology scores of all participants were tested in pre- and post-testing sessions and were then compared with a waiting control group. In the total group of patients, the results indicate an increase in cognitive performance in the domains visual learning, working memory and speed of processing, a decrease in state anxiety and an increase in subjective quality of life between pre- and post-testing. The effects in SZ patients compared with MDD patients were stronger for cognitive performance, whereas there were stronger effects in MDD patients compared with SZ patients in individual psychopathology values. MDD patients showed a significant reduction in depressive symptoms and state anxiety values after the intervention period. SZ patients reduced their negative symptoms severity from pre- to post-testing. In sum, the effects for the combined training were superior to the other forms of treatment. Physical exercise may help to reduce psychopathological symptoms and improve cognitive skills. The intervention routines employed in this study promise to add the current psychopathological and medical treatment options and could aid the transition to a multidisciplinary approach. However, a limitation of the current study is the short time interval for interventions (6 weeks including pre- and post-testing).
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Walther S, Stegmayer K, Horn H, Razavi N, Müller TJ, Strik W. Physical Activity in Schizophrenia is Higher in the First Episode than in Subsequent Ones. Front Psychiatry 2014; 5:191. [PMID: 25601842 PMCID: PMC4283447 DOI: 10.3389/fpsyt.2014.00191] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/15/2014] [Indexed: 12/29/2022] Open
Abstract
Schizophrenia is frequently associated with abnormal motor behavior, particularly hypokinesia. The course of the illness tends to deteriorate in the first years. We aimed to assess gross motor activity in patients with a first episode (n = 33) and multiple episodes (n = 115) of schizophrenia spectrum disorders using wrist actigraphy. First episode patients were younger, had higher motor activity and reduced negative symptom severity. Covarying for age, chlorpromazine equivalents, and negative symptoms, first episode patients still had higher motor activity. This was also true after excluding patients with schizophreniform disorder from the analyses. In first episode patients, but not in patients with multiple episodes, motor activity was correlated with antipsychotic dosage. In conclusion, after controlling for variables related to disorder chronicity, patients with first episodes were still more active than patients with multiple episodes. Thus, reduced motor activity is a marker of deterioration in the course of schizophrenia spectrum disorders.
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Affiliation(s)
| | | | - Helge Horn
- University Hospital of Psychiatry , Bern , Switzerland
| | - Nadja Razavi
- University Hospital of Psychiatry , Bern , Switzerland
| | | | - Werner Strik
- University Hospital of Psychiatry , Bern , Switzerland
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Schmitt A, Falkai P. Impact of lifestyle in severe psychiatric disorders and brain morphology. Eur Arch Psychiatry Clin Neurosci 2013; 263:449-50. [PMID: 23892771 DOI: 10.1007/s00406-013-0430-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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